Main menu

Answers to 5 Common Questions About Texas Health Insurance

Although Texas ranks the highest among U.S. states in the number of uninsured residents, obtaining affordable Texas medical insurance is easier and more affordable than you think. Here are answers to five common questions about getting health insurance in Texas.

1. I’m young and healthy. Why should I spend money for medical insurance that I’ll never use?

Having insurance is like carrying an umbrella. You may not need it most of the time, but when there’s a torrential downpour you’ll be glad you have it. Even young and healthy people have accidents, seasonal illnesses, and sometimes tragic health issues. If you wind up having a serious medical condition, it can become very difficult to obtain Texas medical insurance, or your preexisting condition may be excluded from your coverage. In addition, you can get much lower premiums when you’re young and healthy, so health insurance provides excellent protection at very little cost.

2. Is there a benefit to using a health insurance agency, as opposed to getting quotes for policies on my own or going through a single agent?

A health insurance agency provides a number of benefits. First, they have established relationships with many, many insurance companies. This means that they have access to all of the best Texas medical insurance plans in the marketplace, while not having a bias toward any single insurer. This is in contrast to some individual agents, who work on behalf of one or two companies, and who will try and push you to sign up with their company. While you can research various plans on your own, a health insurance agency will do the legwork for you and present you will all available options, at no charge to you.

3. What’s the most important feature to consider when buying health insurance?

There are two important features that people often overlook: the lifetime maximum coverage and the maximum out-of-pocket expense. Although your more immediate concerns might be co-payments for doctors’ visits and prescription coverage, if you or a family member experiences a catastrophic illness, your overall coverage and out-of-pocket costs are much more crucial. Look for a policy that offers lifetime maximum coverage of $3 million or more, and a yearly out-of-pocket maximum in the $2,000 to $3,000 range.

4. Can I trust online comparisons for Texas health insurance?

Yes. The law requires that identical plans have identical pricing, regardless of whether you go directly through the insurer or use a health insurance agency. In other words, if you’re looking at the XYZ company’s Plan A, you will receive the same quote whether you get it online, place a phone call, or visit an insurance agency or company. Keep in mind though, that the price you pay may depend upon a number of variables, including your age, your gender, whether or not you smoke, and any pre-existing medical conditions that you may have. The final price is in large part determined by your medical history.

5. What’s the difference between an HMO and a PPO?

When it comes to Texas medical insurance, a health maintenance organization (HMO) requires that, for non-emergency services, you use their physicians and hospitals. A preferred provider organization (PPO) allows you to visit any health care provider, but gives you more benefits if you use health care professionals and services within their network.